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• W4313235910 abstract "Introduction: Guillain Barre Syndrome (GBS) challenges us with varying severity, inconsistent response to therapy and uncertain recovery. It is an immune-mediated disorder, and intravenous immunoglobulin (IVIG) is used as therapy. We hypothesize that Immunoglobulin G (IgG) levels before and after therapy may correlate with functional status outcomes (MRC sum score, GBS disability score) at different time points. Methods: All children aged < 12 years with a diagnosis of GBS were enrolled prospectively from a tertiary referral pediatric hospital between July 2019 and December 2021. Children with recurrent GBS or chronic neuromuscular disorders were excluded. All patients received IVIG (2gm/kg) as primary therapy. Serum IgG levels were measured at enrolment, 2 weeks, 4 weeks, and 3 months. IgG levels and changes in IgG levels from baseline were described, and a correlation with outcomes was seen. Results: 70 patients were enrolled, with a median age of 6.5 years. Forty-six (66%) of them were boys. Nerve conduction studies showed a predominance of acute motor axonal neuropathy (46, 66%). Nineteen (27.1%) children required mechanical ventilation, and the median hospital stay was 9 days. Median IgG levels at admission, 2 weeks, 4 weeks, and 3 months were 10.1, 17.9, 13.0 and 9.9 g/L, respectively. Higher IgG levels and higher increment in IgG levels at 2 weeks were associated with better functional status at 2 weeks. A lower IgG level at 2 weeks (16.01 vs 20.56, p=0.006) and a lower ΔIgG level at 2 weeks (6.83 vs 10.03, p=0.041) were significantly associated with an inability to walk independently at 3 months. Higher ΔIgG levels at 2 weeks correlated with shorter overall hospital stay (r = -0.381, p=0.001). The ten patients who needed a second dose of IVIG had nonsignificant lower IgG and lower ΔIgG levels at 2 weeks. These children had a higher IgG level at 4 weeks (16.2 vs 13.2, p=0.042), higher ΔIgG levels at 4 weeks (6.2 vs 3.1, p=0.030), and functional status outcomes at 3 months were comparable to those who did not. Conclusions: IgG levels and their increment after IVIG therapy may predict outcomes in children with GBS. These measures may also be used to decide the utility of the second dose of IVIG in the event of no / partial response to the first dose." @default.
• W4313235910 created "2023-01-06" @default.
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• W4313235910 date "2022-12-15" @default.
• W4313235910 modified "2023-09-25" @default.
• W4313235910 title "628: SERIAL IMMUNOGLOBULIN G LEVELS AND THEIR CORRELATION WITH FUNCTIONAL OUTCOME IN CHILDREN WITH GBS" @default.
• W4313235910 doi "https://doi.org/10.1097/01.ccm.0000908244.49969.af" @default.
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